title: DVT prophylaxis after TKA: routine anticoagulation vs risk screening approach - a randomized study.
abstract: The American College of Chest Physicians (ACCP) recommended routine anticoagulation for thromboprophylaxis in patients undergoing lower limb arthroplasty. We compared results of routine anticoagulation Vs risk stratified approach for Deep Venous Thrombosis (DVT) prophylaxis after TKA in terms of symptomatic DVT and wound complications. Nine hundred TKAs done in 673 patients were randomized after DVT risk screening to routine anticoagulation (n = 450) or to risk stratification (n = 450) and selective anticoagulation. 194 patients in the risk screening group received only Aspirin. Primary outcome was symptomatic DVT and wound complication. This randomized study showed that the symptomatic DVT rates after TKA were similar whether patients were routinely anticoagulated or selectively anticoagulated after risk screening. However there was a significantly higher incidence of wound complications (P < 0.014) after routine anticoagulation.
authors.affiliation: Joint Replacement Centre, Army Hospital R & R, New Delhi.
authors.forename: Vikas
authors.initials: V
authors.lastname: Kulshrestha
authors.forename: Santhosh
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001168:Arthritis / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use; D018890:Chemoprevention; D005260:Female; D006406:Hematoma / Q000209:etiology; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D001241:Aspirin
keywords: DVT; TKA; anticoagulation; aspirin; wound complication